TALKS ON HEALTH 



FOR 



Georgia Teachers 




-: 



Issued from the 5tate Department of Education 
Atlanta, Ga., March 1, 1911 



M. L. BRITTAIN 

State School Commissioner 






- 



FOREWORD. 

With the exception of the first and last topics, this Bulletin 
has been prepared at my request by Dr. A. G. Fort, with the 
approval of the Secretary of the State Board of Health. Our 
greatest thinkers agree with Herbert Spencer that these sub- 
jects concerning healthful living are of vast importance in 
our educational work. The prevention of disease and the 
preservation of health through the dissemination of knowledge 
are among our most important civic obligations. To gain all 
knowledge will be of litle worth if the bodies of our children 
are weakened through ignorance of the simple laws of sani- 
tation. 

Teachers and school officials are urged to give careful at- 
tention to the suggestions made in this pamphlet. The sub- 
stance of the articles should be presented orally to the pupils 
in such language as all can understand. Secure the help of a 
good physician and occasionally invite the parents and friends 
to take part in the exercises. 

Some of the topics are necessarily disagreeable. It would 
be much more pleasant to ask for exercises on "the Good, the 
True, and the Beautiful" or some other aesthetic subject, but 
no one acquainted with the facts can honestly disguise to him- 
self the real need for the practical instruction given in the 
following pages. Please do not neglect these distasteful 
lessons. The Augean task must not have appealed to the 
classic taste of the old Greek, but this did not deter him from 
his disagreeable duty. I confidently appeal to the civic pride 
and patriotism of every teacher to aid in this important work. 
By tactful management, these talks can be properly presented. 
It is a matter of common sense as well as civilization, that 
help and instruction be given on subjects so vitally concerning 
the health and happiness of all. 

Sincerely yours, 

M. L. Brittain, 
State School Commissioner. 

Atlanta, Georgia, March 1, 1911. 



CHAPTER I. 
The Value of Health. 

The nation's greatest asset is its people. This asset is 
valuable only in proportion to the physical, mental and moral 
development of each individual. "With health, the limit of 
man's ability is almost boundless, but when his powers are 
dwarfed by disease he can hope for little and even this is 
rarely attained. Health is necessary for the enjoyment of 
life. It is necessary for the application of education to man's 
work. ''Y\ 'hat shall it profit a nation if through education it 
gain all power, intellectual and spiritual, but through disease 
lose its physical vigor, and its body, by which alone it can act 
upon the world?" 

Health is wealth, and on the value of health depends the 
value of man. Six hundred thousand Americans die every 
year from preventable disease, and three million are now 
sick from ignorance or inattention to the laws of sanitation. 
It is stated on good authority that the value of an average 
American is $2,900. If we accept this as true, our loss from 
preventable death is $1,740,000,000.00 annually. Add to this 
the $1,000,000,000 which political economists estimate as the 
yearly amount of wasted productive energy caused by pre- 
ventable disease, to our country. Add to this the expense to 
the people caused by typhoid fever, malaria, measles, diph- 
theria, dysenteries, pellagra, hook-worm and summer diar- 
rhoeas. Add the anxiety of fond parents and loving friends, 
and the heartaches of millions from the loss of loved ones. 
Add all of these and then and not till then can we have the 
proper idea of the value of health. 

It will surprise many to know that leading magazines have 
repeatedly made the statement that the city has become ac- 
tually more sanitary than the country. A prominent health 
commissioner of a southern state writes in the journal of the 
American Medical Association that the changes for the better 
in the hygiene of the cities has placed them in advance of 



the country in this particular. Whether this statement is cor- 
rect or not, certainly the organization of health departments, 
and the supervision of water and milk supplies have been of 
immense advantage in promoting the healthfulness of city 
life. 

While this is true of the city, the country districts and 
many small towns as a rule, have had neither efficient orga- 
nization nor health supervision. The reporting to the proper 
health authorities of even the most dangerous of contagious 
diseases in very few communities has had adequate attention. 

The reason assigned for this state of things is because there 
is a greater survival of the individualistic idea of life in the 
country than in the city. In thickly populated communi- 
ties, no man lives unto himself alone. Government is at the 
elbow of every citizen, while it touches the man in the country 
to a limited degree only. The very fact that health depart- 
ments are so obviously necessary in centers of population, gen- 
erally convinces the people of such communities of the im- 
portance of sanitary measures. The outskirts of many of our 
cities, however, are in many instances, sadly in need of sani- 
tary supervision. 

Naturally the country is more healthful, but this is not the 
case where the obvious laws of sanitation are neglected. If 
wells are carelessly dug, or if they are built without protection 
against drainage from the stable and out-houses, it is practi- 
cally impossible to avoid illness. The outdoor life of the far- 
mer is a most efficient aid in repelling disease of all kinds, 
yet even under these favorable circumstances, the body will 
soon suffer without actual knowledge concerning food and 
cooking, as well as sanitary living. 

The truth is that all of us, whether living in the city or 
country, should pay attention to the laws of health, and learn 
everything that will enable us to live happier and more 
useful lives. 

If every child in the state should sign the resolutions 
below, and keep them, it would mean much for the welfare 
and happiness of our people. They are adapted from the 
Student's Health Creed, and contain material for many health 
talks: 



MY HEALTH CREED. 

I believe my body and good health are sacred. If I am 
sick, it will very probably be because I have violated some one 
or more of nature's laws. 

I will study the laws of health and will obey them for my 
own sake. 

I will not wet my fingers in my mouth when turning 
the leaves of books. 

I will not put pencils in my mouth nor wet them with my 
lips. 

I will not put pins or money in my mouth. 

I will use my mouth for eating good, plain food, drinking 
pure water and milk, and for saying good and kind words. 

I will always chew my food thoroughly, and never drink 
whiskey or wine. 

I will not cough or sneeze without turning my face or hold- 
ing a handkerchief before my mouth. Polite people never 
cough in public if they can prevent it. 

I will keep my face, hands, and finger nails as clean as 
possible. 

I will not spit on floors, stairways, or sidewalks, and will 
try not to spit at all ; ladies and gentlemen try to avoid 
this bad habit. 

I will wash my mouth every morning on getting up and at 
night on going to bed, and will use a tooth brush if I can get 
one. 

I will be clean in body, clean in mind, and avoid all habits 
that may give offense to others. 

I will get all the fresh air I can and will open wide my 
windows when I go to bed. 



Name of Student. 



CHAPTER II. 

EYES. 

Only a few of the diseases of the eye may be discussed in 
the space allowed here : 

1. Those diseases which are communicable. 

2. Those diseases which have directly or indirectly to do 
with the physical and mental development of the child, such 
as near-sightedness, far-sightedness, and irregularity in the 
contour of the cornea or the part of the eye through which 
light enters. 

It is well for us to know that simple conjunctivitis, or ordi- 
nary sore eyes, is a germ disease and is communicable. 
Usually both eyes are affected. It is more common in the 
spring and summer and is quite often epidemic. The in- 
fection is sometimes carried by means of towels, handker- 
chiefs, etc., especially in schools, hotels, and hospitals. In 
about 36 hours after the eyes become infected, they begin to 
sting and gradually redden. The lids are often glnc-1 together 
from the discharge. 

Another form of sore eyes is what is commonly known as 
''granulated eye-lids," resembling, in a degree, a more severe 
disease called "trachoma," which is practically unknown in our 
State, With this infection we have inflamed eyelids, with 
small elevations on them. This condition is said to be slightly 
communicable. It is considered a splendid index to the general 
physical development of a child. 

Attention should be called also to the very severe and 
dangerous condition known as specific conjunctivitis. This 
runs a rapid course and eyesight is often lost. A large per 
cent of blindness from childhood is caused from this form of 
sore eyes. 

A young man, of splendid parentage, and of high educa- 
tional attainments, was rendered practically helpless by this 
disease probably contracted from a towel on a train or 





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steamship. So severe was the infection that his eyesight was 
completely destroyed in a few days. A few words of warning 
might have prevented this calamity. 

To the defects of vision are due much of the mental apathy 
of the unfortunate little ones suffering from troubles of this 
kind. 

By near-sightedness it is meant that the eyeball is too long. 
This condition is frequently acquired through careiess habits 
rather than inherited. The child can sec but poorly at a dis- 
tance, and must hold a book very close to his eyes in order 
to read. 

By far-sightedness, we mean that the eyeball is too short, 
and objects have to be held at a distance in order to be properly 
seen. 

By astigmatism, we mean that the cornea does not have 
the proper uniform convexity. With an eye like this, we see 
distinctly in a straight line only and the letters like a, o, and c, 
cannot always be distinguished. Children suffering from 
these defects strain the muscles of their eyes in the effort to 
see. The far-sighted boy can learn readily from explanation 
given on the blackboard. The near-sighted boy is backward 
when taught by object lessons and illustrations. The astig- 
matic child as a rule reads poorly. 

The strain occasioned by the constant effort of these chil- 
dren to properly focus their eyes upon objects, causes head- 
ache, indigestion, and various nervous disorders. They be- 
long to the class who grasp every opportunity for staying at 
home and are usually the first to quit school. To none 
does medical attention offer a brighter future than to those 
suffering from these defects of vision. Many a child's whole 
life is blighted and his opportunities for obtaining an educa- 
tion lost from lack of glasses properly fitted. 

Herewith is given the Snelling Test Sheet, which is a rec- 
ognized standard. Directions for its use are as follows : 

Fasten the sheet to the wall so that the letters will be on 
a level with the eyes of the child seated 20 feet distant. The 
light should be. good but should not shine in the child's face 

10 



or on the chart. Test each eye separately and then both 
eyes together. Cover one eye with a card and let the child 
read, from left to right, the smallest letters that can be clearly 
seen. Then cover the other eye and have him read from right 
to left. The number over each line of the test letters shows 
the distance at which a normal eye should read them. Then 
test them, using both eyes as before. If the defect in vision 
is considerable, advise the parent to consult a competent eye 
specialist. Of course the test could not be made with children 
unable to read. 



CHAPTER HI. 
EARS. 
In the discussion of the ear, it is well to say something- 
concerning its anatomy and physiology in order to properly 
understand the effect of various conditions on heanng. The 
outer ear is the part we see. The middle ear ,s hke a closed 
box The outer side of it is covered by the drum-membrane, 
a glistening tissue which can be seen by looking mto the ear 
ro t the outside. To this is attached one of the three small 
ones of the ear. Within this enclosed chamber is am, earned 
through a little canal known as the "eustaclnan tube, which 
xte d from the back of the nose into the middle ear. Sound 
s transmitted by sound waves, and the motion ot these cause 
a vibration of the drum membrane, and in turn, this vibra 
ion s transmitted by the chain of small bones and the am 
n th enclosed box to the inner wall. From here, they are 
carried Trough the nerves to the center of hearing in the 
"an Z* disease of the nose or throat which might cause 
dosing o the eustachian tubes interferes with hearing ; first 
rom a & lack of equalization of air in the muidle ear and 
second by forcing or allowing pus or germs to be orced into 
t hrough this tube ; this causes inflammation, which may pro- 
duce pefforation of the drum, a growing together of the sma 

bones or an injury to the ends ^.^.^1^1^- 
of these conditions will interfere with heanng Lack of atten 
ton or apparent indifference in many children is due to a 
defect of E kind, and many so-called dull children are men- 
tallv hrip-ht but are more or less deaf. 

nS connection, careful attention should be paid to ade 



12 



Such children are absent-minded, and have the appearance 
of being inattentive, which may be due to mental dullness, 
impaired hearing, or both. These defects should receive at- 
tention for the following reasons, which are given by good 
authorities : 

1st. The ever threatening danger of ear complications, 
inflammation of the middle ear, — deafness, mastoiditis, and 
meningitis. 

2nd.. The greater liability to serious infectious diseases — 
especially scarlet fever and diphtheria. 

3rd. The influence of the obstruction on the general 
health, mental development and the formation of the face, 
results which may remain permanently if the glands them- 
selves undergo atrophy. 

A simple test for hearing is given in order that the teacher 
may ascertain the acuteness of this faculty in each child, 
and thereby inform the parent and himself of any defect. The 
majority of cases of partial deafness and other diseases of the 
ear found among children are caused by some slight affection 
of the throat or nose, and may be easily cured if treatment 
is not delayed too long. A simple method taken from the di- 
rections for testing hearing, prepared by the State Board of 
Health of Massachusetts is as follows : "The examination 
should be conducted in a room not less than 25 or 30 feet long 
and in as quiet a place as possible. The floor should be 
marked off with parallel lines, one foot apart. The child should 
stand in the first space. 

The examination should be made with the words whis- 
pered or spoken in a low tone of voice; the child should 
repeat what he hears, and the distance at which words can 
be heard distinctly should be noted. 

The examiner should attempt to form standards by test- 
ting persons of normal hearing at normal distances. In a still 
room, the standard whisper should be heard easily at 25 feet ; 
the whisper of a low voice can be hard from 35 to 40 feet, and of 
a loud voice from 45 to 60 feet. The two ears should be tested 
separately. 



13 



CHAPTER IV. 
NOSE. 

The normal nose is such that the inhaled air is properly 
warmed before reaching the lung. Any impairment tends to 
mouth-breathing and improper heating of air. It is a fact 
that mouth-breathers are more subject to diseases of the 
nasal tract, such as "colds" and "catarrh" than are those 
who breathe normally. 

We have been led to believe that colds are trivial troubles 
but as we watch their deleterious effects when neglected, we 
shall be impressed with the fact that they frequently lead 
to some serious malady. Colds are caused from germs and 
are contagious. No place is better suited than the school- 
room for spreading these troubles. Draughts and poor ven- 
tilation by reducing the resistant power of the child make 
infection easy. How are we to prevent taking cold? 1st. 
By proper dressing; according to many authorities wool next 
to the skin is preferable to cotton or linen, as it permits rapid 
evaporation of perspiration. 2nd. Overshoes should be used 
to prevent the feet from becoming wet, but should never be 
worn in the house. 3rd. Sleep in well ventilated rooms ; the 
practice of sleeping out-of-doors is a good one when climate 
will permit. 4th. Avoid sudden changes in temperature and 
never allow yourself to become suddenly chilled. 5th. Eat 
wholesome food, and not too much of it. 6th. Keep yourself 
in good physical condition. 

Small tumors called polypi occasionally fill the nasal pas- 
sages, and when found, should be promptly and carefully 
removed by a competent physician. Mucus and crusts often 
obstruct the nose ; under such circumstances a nasal douche of 
warm salt water is serviceable. 



14 



CHAPTER V. 
MOUTH. 

The mouth should be used for food, drink and speech, but 
is not a proper receptacle for pencils, paper, or tobacco. 

Food is necessary for our maintenance. The value of it 
is dependent upon its food value and proper assimilation. 
Thorough mastication or grinding by the teeth is essential to 
normal digestion, and to properly masticate our food we must 
keep our teeth or grinders in first class condition. It would 
seem unnecessary to call attention to the necessity for keeping 
the teeth clean, but the examination of many children proves 
the fact. Decayed teeth cause offensive breath. They pre- 
vent proper mastication of food, and therefore impair di- 
gestion. The statement that you should put nothing in your 
mouth except "food, drink, and toothbrush," means a great 
deal, and if observed, would prevent much suffering. 

The following catechism taken from Civics and Health by 
Allen is instructive : 

Q. What are the teeth for? 

A. To masticate food : that is, grind it into fine particles, 
mix it with saliva, and so begin its digestion ; also to aid in 
speaking and singing. 

Q. How long should they last? 

A. To the very end of life. 

Q. How do we lose them ? 

A. By decay, by loosening, and by accident. 

Q. What causes teeth to decay? 

A. Particles of food decaying in contact with them. 

Q. Where does food lodge? 

A. All along the edges of the gums, in the spaces between 
the teeth, and in the crevices of their grinding surfaces. 

Q. Can we prevent this loss? 

A. Yes, to a large extent. 

Q. How can we do it? 

A. By using the teeth properly and by keeping them clean 
and the gums healthy. 

W 



Q. What does using them properly mean? 

A. 1. Using sufficient hard or fibrous food to give the teeth 
and gums full exercise. 

2. Taking time enough to masticate food thoroughly be- 
fore swallowing. 

Q. How often should teeth be cleaned? 

A. As often as they are used. 

Q. When should they be cleaned? 

A. Immediately after the morning and noonday meals, 
and before going to bed. 

Q. By what means should they be cleaned? 

A. A moderately stiff brush, water, and floss silk are the 
best possible materials for this purpose. 

Q. How should these be used? 

A. The brush should be first used in a general way, high 
up on the gums lengthwise of the jaws, to remove large par- 
ticles and stimulate the gums ; then the brush and the teeth 
should be carefully rinsed with water; the brush should next 
be used with a rolling or circular motion, so that the bristles 
will follow the lines of all the grooves and spaces in which the 
particles of food have lodged, and so brush them out. Then 
again the mouth should be rinsed with water. 

Q. Should the gums be brushed? 

A. iYes, moderate friction helps to keep them healthy. 

O. How can the spaces between the teeth be reached? 

A. By dental floss silk passed between the teeth, drawn 
carefully back against the side of each tooth in turn and drawn 
out towards the grinding end of the teeth, and this repeated 
several times in each space. 



L6 



CHAPTER VI. 
COMMUNICABLE DISEASES: 

A communicable disease is one that is carried from the sick 
to the well. We are living in a new age, one of progressive 
enlightenment. In days gone by, when population was less 
dense, communicable diseases were not so much considered in 
public health matters. Now, when no man lives to himself, 
things are different. Formerly, time and attention were given 
to protection against attacks of savages, wild beasts and van- 
dals. Cooperation in this line was easily secured. Disease was 
looked upon as a necessity. 

Modern science has proven that many diseases are prevent- 
able, and the great victories of peace in ridding Cuba of yel- 
low fever, and making the Canal Zone as healthful as any of 
our modern cities — and more so than most of them — marks 
an epoch in our forward movement. 

The discovery of the cause of disease enables us to prevent 
it in a large measure. Ignorance alone is responsible for the 
untimely death of hundreds of thousands of Americans an- 
nually. In no place can facts be better taught children and 
the people, generally, than by the instructors in the school 
room, and no field is broader, and no path leads to a more 
praiseworthy goal than that of teaching the people how to live 
in order that they may be free from disease, and attain as 
near as possible to physical and mental perfection. 

Not all diseases which are communicable can be discussed 
by reason of lack of space, but the most common, and those 
which have principally to do with school children and their 
development are here considered. 



17 



CHAPTER VII. 
1.— TUBERCULOSIS. 

Of all the enemies of mankind, tuberculosis, in its various 
forms takes the first place. This affliction may occur in almost 
every part of the body and produce disease in every organ. 
Preeminent among these is the terrible malady known as con- 
sumption, which is tuberculosis of the lungs. As a result of 
the labors of thousands of patient, self-sacrificing investigators, 
the peculiarities of this malady are fairly well understood, 
and if we were to apply the knowledge which we now pos- 
sess, in our attempts to free ourselves from its ravages, there 
is no question but that within a comparatively short time 
the disease would practically cease to exist. 

1st. Character of the Disease: — Tuberculosis is pro- 
duced by a germ known as the bacillus tuberculosis. This 
germ occurs in man and is also widely distributed among the 
lower animals. 

2nd. Course of the Disease : — As it is from tuberculosis of 
the lungs or consumption that the contagion is generally 
spread, and as this is the usual form of the disease, a brief 
description of it follows : 

Tuberculosis of the lungs generally comes on insidiously, 
there being usually no definite period of time from which the 
sufferer can date its beginning. 

In the early stages there is loss of appetite, and a pro- 
nounced feeling of weakness, followed by a slight cough ; 
the latter symptom frequently leads patients erroneously to 
believe that their trouble began with a bad cold, when, as a 
matter of fact, the catarrhal trouble of the throat and bron- 
chial tubes was originally produced by the germs of tubercu- 
losis. 

As the disease^progresses, the victim complains of fever 
and chills. These symptoms are often periodic, leading one to 
believe that the trouble is malarial fever. 

Rapid loss of flesh is one of the earliest and most common 
symptoms, 

18 



Night sweats, which are very exhausting, occur frequently 
but are not invariable. 

The symptoms above enumerated continue and grow worse, 
and in quite a large proportion of cases there is expectoration 
of blood, which in some instances may be so pronounced as to 
become a distinct hemorrhage. 

3rd. Treatment of the Disease: — The treatment of tu- 
berculosis by drugs, alone, has proven a failure, but recent 
investigations have shown that a large number of persons 
afflicted will recover if placed under proper hygienic condi- 
tions. In case of tuberculosis look first to guidance by your 
physician, then to sunlight, to open air, a nourishing diet and 
rest. Avoid alcohol in all its forms. 

Inasmuch as treatment of incipient cases is so generally 
successful, do not delay having an examination made, if any 
of the symptoms mentioned present themselves. 

4th. Modes oE Infection : — Hereditary tuberculosis — not- 
withstanding the popular idea to the contrary- — is practically 
unknown, though there is no doubt but that these persons in 
whose family consumption exists, are more prone to contract 
the disease, than are others. A tendency toward the disease, 
or a lack of resisting power may be inherited, but the disease 
itself is contracted. 

In just what manner the germs of consumption gain en- 
trance to the human body, we are more or less uncertain, but 
we are led to believe that in many instances, they pass in by 
means of the air as it is inhaled. 

In a small percentage of cases, the infection gains en- 
trance to the human body through an abrasion of the skin, 
or through some mucous membrane. Finally the germs are 
often taken in with the food that we eat, or by putting ob- 
jects upon which they are present into the mouth, or by 
eating with hands which have been contaminated and not 
washed. 

Milk is unquestionably the most common food through 
which we contract the disease, as a large percent of cows have 
tuberculosis, and in this case, their milk is frequently infected 
with the germs. 

Of quite as much importance as the introduction of 

10 



the germ into the body is the resisting power of the 
individual at the time when this occurs, since the disease 
can make no progress unless the tissues have become 
susceptible through lowered resistance. All things then that 
have the effect of lowering the vitality of the body act as 
predisposing causes to consumption; such, for example, as 
want of proper food, lack of sleep, improper clothing in cold 
and wet weather, and living in damp and improperly ventilated 
houses ; excesses, particularly the taking of alcohol, conduce to 
the development of the disease — long-continued inebriety being 
beyond doubt the cause that most frequently leads to consump- 
tion. It is a common error that alcoholic stimulants tend to 
ward off consumption, and it is highly probable that these sub- 
stances not only do not act in a curative way on those who 
have already contracted the disease, but are positively detri- 
mental. In order then to avoid consumption — and this is 
particularly of importance for those in whose family there 
is a predisposition to the disease — the individual should live 
soberly, should try at all times to obtain a reasonable amount 
of good food, should sleep a sufficient number of hours, and 
should be clothed properly, particularly in the winter. Those 
who devote their time and energy to the performance of their 
work — being careful of course not to labor excessively — are 
much more apt to escape consumption than those who do other- 
wise. It is particularly of importance that those who have a 
tendency towards consumption should early learn, and 
throughout life practice the habit of breathing through the 
nose; if this rule be followed there is no question but that a 
large percentage, not only of the germs of consumption, but 
other bacteria as well, are filtered out during their passage 
through the nose and do not reach the lung substance. Clean- 
liness is also of importance — a bath taken each morning in 
moderately cold water being conducive to health, not only as 
regards consumption but other diseases as well. It is of course 
necessary that dwelling houses should be kept thoroughly 
clean. 

5th. Advice to Diseased Persons : — In all cases where a 
person observes in himself, or in those for whom he is respon- 
sible, the symptoms already detailed, it is his duty to con- 

20 



suit at once an intelligent physician, and if it be found that tu- 
berculosis is present, every precaution should be taken by the 
diseased individual to prevent the further spread of the malady. 
The sputum that is constantly being coughed up contains myri- 
ads of the germs, and it is of the utmost importance, in order 
to prevent other persons in the neighborhood from being in- 
fected, that it be destroyed. The patient should at all times 
carry about with him either a small receptacle for expectoration 
or a large cloth which would answer the same purpose, and in 
either case the sputum should be burned ; if this be imprac- 
tical, it should be placed in a solution of some good antiseptic, 
such as a saturated solution of carbolic acid, or a 1 to 1,000 
solution of corrosive sublimate in water. The patient's hand- 
kerchief should be thoroughly boiled, and his clothing should 
receive like treatment. Every precaution should at all times 
be observed in order to prevent the sputum getting on the 
furniture or floors, as, under such circumstances, it quickly 
dries and being broken up into small particles is carried by 
means of the air to other parts of the house. 

The patient should always remember that the quicker he 
is placed under proper treatment, the more the chances of 
ultimate recovery; in the early stages almost all of the cases 
are curable, but later this is not often accomplished. 



21 



CHAPTER VIII. 
2.— DIPHTHERIA. 

Diphtheria is a germ disease produced by the diptheria ba- 
cillus and is among the most communicable and fatal maladies 
of children. It is common to all climates and occurs most 
frequently during the winter months. 

Cause of the Disease : — The germs grow generally on the 
mucus membrane of the tonsils, but often exist in the mouth, 
the nose, and the wind-pipe. 

There are various symptoms: 

Sore throat is practically always one of the first ; then the 
temperature rises and there is lassitude and that peculiar ap- 
pearance of the face which is often seen in serious illness. Gen- 
erally, there is a "kidglove-like" membrane formed on the ton- 
sils ; in the nose, or throat. In the formation of this membrane 
poisons are produced from the germs. These are absorbed into 
the general system and produce the symptoms named above. 
So variable are the effects of the infection that all children with 
evidence of sore throat or inflamed tonsils should have cultures 
made from their throats before they are allowed to continue 
in school. This is already the custom as well as the law in 
many cities. 

The mild cases often recover without treatment, but a large 
percentage of those affected with the severe type succumb to 
the disease, especially if proper attention is not given. 

Several cities in our State provide tubes for cultures in order 
to make sure of the diagnosis, and the State Board of Health 
at Atlanta will do likewise for the people at large. 

Treatment: — Treatment of this disease should always be 
under the direction of a physician. The discovery of antitoxin 
has reduced the death rate to one-third of what it was a few 
years ago. This remedy is made at the laboratory of the State 
Board of Health at Atlanta, and is furnished free to all citizens 
of Georgia who may need it and are not able to pay for it. 

Modes of Infection : — Through the air passages, the germs 

22 



usually gain a hold in the nose, mouth, or tonsils. This is not 
the only method of infection, as the germs are often taken 
into the mouth through pencils, chewing gum, and food — es- 
pecially milk. ; . / 

Inasmuch as the disease is so readily transmitted, and the 
germs linger in the throat of the victim after apparent re- 
covery, the doctor's certificate should be required before a 
child who has recovered from this malady returns to school. 

Prevention: — We readily see from the above discussion 
that an ounce of prevention is worth a pound of cure. 

It is well to insist upon thorough examination of all sus^ 
picious cases of sore throat. 

Isolation and quarantine of all cases of diphtheria, and thor- 
ough disinfection of the apartments to which the patients have 
had access should be required. All persons known to be ex- 
posed should be closely watched for symptoms. Only by rig- 
tf.'y following these instructions can the disease be prevented 
and controlled. (See note on disinfection following article 
on typhoid fever. ) 



23 



CHAPTER IX. 
3.— TYPHOID FEVER. 

Typhoid fever has existed in our State for many years and 
its percentage of fatalities is great. 

This being a germ disease is preventable. The following 
article will enable you as teacher to aid in ridding the people 
of this menace to public health. 

Character of the Disease: — This fever develops, as a 
rule, quite slowly, the first symptoms being loss of appetite, 
headache, and a marked fatigue on slight exertion. The symp- 
toms gradually grow worse, fever develops, and the patient of- 
ten suffers with chilly sensations. The temperature gradu- 
ally rises. In many cases no symptoms exist that indicate in- 
flammation in the bowels, but in the severe forms, diarrhoea 
usually comes on during the first week and continues through- 
out the course of the disease. During the second week, the 
above symptoms are more severe. When the disease follows 
a normal course, the symptoms during the third week grad- 
ually abate. 

The mortality of this disease varies from five to twenty 
per cent., depending upon its character, and the nature of treat- 
ment and nursing that the patient receives. 

Treatment of the Disease : — As soon as the symptoms al- 
ready detailed appear, the child should be sent home and 
placed under the care of a physician. 

Modes oe Infection : — It is clear that typhoid fever is the 
result of the entrance into the body of some minute form of 
germ life ; whether this be the bacterium generally supposed to 
induce the disease or not, this contagion is beyond question a 
living something which multiplies with great rapidity under 
proper conditions, and, escaping from the bodies of those in- 
fected with the disease, in one way or another, reaches other 
individuals. It is beyond question true that the virus passes 
from the body of those infected by means of the excretory 

24 



organs, and it is likely that the secretions from the mouth and 
nose frequently contain the germs that cause the fever. 

As the germs are extraordinarily minute, a very small 
amount of any of them might produce the disease in healthy 
individuals if they were to get into their bodies through 
water, milk, or any uncooked food, find lodgment about 
the nose or mouth, or get upon the hands of other 
persons. It should also be remembered that the virus may 
easily get upon cooking-utensils, drinking-cups, bed-linen, and 
other articles with which we are constantly brought into close 
contact, and that the disease might be transmitted in this way. 
The malady may be carried from place to place by insects, 
particularly flies; the latter may readily get enough infectious 
material upon their legs in various ways, and then, crawling 
over food, leave the deadly poison deposited upon it. 

Isolation of Patients : — Wherever possible, patients with 
typhoid fever should be completely isolated, since, if this is 
not done, other members of the family are almost sure to 
contract the malady — a result which almost every one has 
seen who has had any experience with the disease. Wherever 
possible, patients should be sent to a hospital, but where this 
can not be done they should be isolated as much as possible. 
We should be particularly careful to prevent children from 
coming in contact with them, as it has been shown that they 
contract the disease much more readily than grown people. 
It is also of importance that persons should not, unless com- 
pelled, sit for any length of time in the room with a person 
suffering from typhoid fever, and, above all, under no circum- 
stances should cooking and eating be done in the sick cham- 
ber. 

The room in which the patient is placed should be furnished 
only with those things absolutely necessary, and it is partic- 
ularly desirable that carpets and curtains should be removed. 
It is well to wash the floor each day with some antiseptic 
solution. 

Those persons who come in contact with typhoid fever pa- 
tients should wear outer clothing which can be easily washed 
and boiled. After touching the patient, or any of his cloth- 
ing, the hands should be at once thoroughly scrubbed in an 

25 



antiseptic solution. Of course, under no circumstances, should 
the nurse eat or drink from the same vessels with the patient. 

Disinfection. — All clothing that comes in contact with 
the typhoid fever patient should be thoroughly disinfected. 
This is best accomplished by boiling, but in cases where 
this can not be at once carried out, it is advisable to use 
some chemical antiseptic ; of these, perhaps the best is creo- 
carboline, which may be employed in a 1-500 solution in wa- 
ter; where this substance is not obtainable, a 5 per cent so- 
lution of carbolic acid in water, or a 1-1000 aqueous solution of 
corrosive sublimate may be employed. The floors should 
be daily washed with one of these solutions. 

The water in which the patient is bathed should likewise 
be disinfected, either by the addition of an ounce of creo-carbo- 
line, or four tablespoonsfuls of chloride of lime ; disinfection 
will be brought about in half an hour, when these directions 
are followed. 

The hands of those coming in contact with the patient 
should likewise be thoroughly washed, either in a solution of 
carbolic acid, or corrosive sublimate of the strength just men- 
tioned. 

Of greatest importance is protection from polluted water, 
milk and food. The fly often carries the disease. Lack of 
attention to outhouses is a prolific source of the malady. Cir- 
culars showing proper construction of closets will be furnished 
on request by the State Board of Health. 

Disinfection of Room. — After the patient recovers, the 
room should be disinfected with formaldehyde gas ob- 
tained from the substance known as "formalin." When 
everything is ready, and the room properly sealed, thir- 
teen ounces of permanganate of potash to each quart of 
formalin are placed in a large vessel, the room being 
closed immediately after the two substances are put to- 
gether; it is important that the permanganate be placed in the 
vessel first. When this method is employed a quart of forma- 
lin should be used to each one thousand cubic feet of air- 
space in the room. As the gas, by this process, comes off with 
great rapidity, it is not necessary to keep the room closed 
as is the case when the older method is employed. Experi- 

26 



merits have shown that complete disinfection is brought 
about in four hours. This method is to be advised for the 
reasons that it acts more quickly than the older one, and 
there is never danger of fire. 

In cases where houses are too open to permit of disinfec- 
tion by means of gas, the sick chamber should be thoroughly 
washed with one of the antiseptics employed for sterilizing 
the clothing. 



27 



CHAPTER X. 
4.— SCARLET FEVER. 

Scarlet fever or scarlatina, as it is often called, is character- 
ized by sudden onset with high fever,, rapid pulse, headache, 
and sore throat. It gets its name from the peculiar scarlet 
rash, which appears on the second day after the attack. The 
exact causative agent has never been discovered, but it is no 
doubt caused by some very minute germ. It, too, belongs to 
the communicable diseases, and next to diptheria is the most 
dreaded of the acute ailments of childhood. It. like diphtheria, 
is more prevalent during the, fall and winter months. 

Every child with high fever and sore throat should be sent 
home at once, and scarlet fever suspected, if it exists in the 
locality. It affects children principally, and while dangerous in 
itself, its after effects are also serious. Kidney trouble and 
acute middle ear disease, often leading to deafness, frequently 
follow even the mild attacks. Isolation and quarantine should 
be instituted in every case of this disease, and kept up until all 
of the scales are completely removed, and everything thor- 
oughly disinfected. Those who have had the disease should 
be looked upon as possible source for infection until physi- 
cian's certificate is received. For disinfection, see this topic 
under typhoid fever. 



CHAPTER XL 
5.— SMALL POX. 

Until the beginning of the nineteenth century smallpox was 
the terror of mankind. Where it originated is a matter of 
doubt. It is, however, certain that it existed in Egypt about 
the middle of the sixth century, A. D. It was brought to Amer- 
ica by the Spaniards. 

Its onset is usually sudden, beginning with a chill or chilly 
sensation and pain in the back, and where the disease exists 
in a locality, a teacher should at once send a child home, if 
suffering with these symptoms. It is communicable from the 
beginning. 

The child should not be allowed to return to school until all 
scabs are removed, and its clothing and home disinfected. 

The story of the inoculation of matter from the hand of 
the dairy maid — suffering from cowpox, contracted by milking 
— into the arm of an eighteen year old boy, and the 
failure of the latter to develop smallpox, is familiar. 
This test was made by Edward Jenner in 1796. He quickly 
proved the value of vaccination and it was introduced into this 
country in 1800. By modern methods, we have eradicated 
practically all of the danger attending the procedure, and the 
same principle used one hundred and twenty years ago is still 
in practice. 

So effectual is vaccination against smallpox, that a German 
physician, in writing an article on the subject, states that he 
has had no opportunity of studying the disease in any of its 
forms in his large clinic for the past nine years. This was the 
result of strict vaccination and revaccination in Germany. 

If every person in our State were vaccinated this disease 
which takes its toll of human lives and of thousands of dollars 
from us every year would soon be a thing of the past. Can we 
not see what it has done for others and apply it for our own 
protection? 

For disinfection note this topic under typhoid fever. 



29 



CHAPTER XII. 
6.— MEASLES. 

Measles is a far more dangerous malady than many think. 
It, too, belongs to the communicable diseases, but the exact na- 
ture of the organism producing it is unknown. 

We do know, however, that it is considered the most conta- 
gious of all the eruptive diseases. The contagious period lasts 
from the very first symptoms until the complete disappearance 
of the eruption. The period of time from exposure till the fir^t 
symptoms are seen is usually from 10 to 12 days, the erup- 
tion appearing about 3 days later, or the fourth day of the 
fever. Reddening of the eyes, sensitiveness to light, head- 
ache, sneezing, and the appearance of a cold are usually the 
first symptoms. 

The eyes should receive special attention, as many defects 
of vision are caused by inflammation during this disease. The 
child should be well protected from exposure, as cases of low- 
ered resistance leading to tuberculosis have been traced to this 
cause. A splendid youth, an honor man in one of the 
best colleges in Georgia, traced his decline in health to ex- 
posure during measles. Fourteen years of study and the at- 
tendant expense, as well as a bright and valuable life were lost 
from this indiscretion. 



30 



CHAPTER XIII. 

HOOKWORMS. 

Of all the intestinal worm diseases, Hookworm is the most 
important subject of study in our section of the country. It 
is said to cause either, directly or indirectly, more deaths 
among the children and more poverty among grown people 
than any other disease. These worms live in the small, intes- 
tine. The number present vary from a few to thousands. They 
are found principally, so far as the United States is concerned, 
in the Southern States, although quite a number of cases 
have been reported from the North. They are grayish white 
in color, about the size of No. 1 thread and about a half inch 
long. 



(( 



Hook* Worm, Natural Size; The Smaller is the Male 

The worms live in the intestine, but do not multiply there. 
They lay eggs by the thousands, and these pass out of the 
alimentary canal, ilf they are allowed to get in the soil, they 
hatch out very small worms, each egg producing one worm. 
After a few days these small embryos, as they are called, 
have the power to penetrate the skin of a person, causing 
"ground-itch" or "dew-poison," the condition very frequently 
seen among children who go with bare feet. Doubtless these 
small worms are occasionally taken into the body with un- 
cooked food and in unclean water. 

Hookworms not only suck blood from the sufferer, but 
also inject a poison into the body. This causes the lack of 
red blood corpuscles (anemia) a condition often seen among 
children. These worms do not remain always attached 
to the same spot in the small intestine, but go from 
one place to another, each time leaving inflammation. This 
disease is often mistaken for malaria. The sufferers are con- 

31 



sidered lazy, shiftless, indifferent, and backward, -md many 
have been punished for these supposed traits wl.jn proper 
treatment for Hookworm disease would have removed them. 
One suffering from hookworms shows the following symp- 
toms : paleness, a whitish yellow skin, lack of physical devel- 
opment, a peculiar white glistening eye, and dry hair. Some 
patients have a peculiar desire to eat such things as dirt, chalk, 
and sticks. 

Hookworm disease is most common in districts which have 
sandy soil, as sand, heat, and moisture are favorable to the 
growth of the worm. Children suffer more frequently than 
grown people, as they sometimes go with bare feet. It is not 
confined to children, nor to the country entirely, and may be 
found in the rich as well as the poor. It occurs almost exclu- 
sively in the rural districts, and is practically confined to those 
who go barefooted or wear leaky shoes. 

The eggs of the worms get in the soil only from people who 
have the disease, so proper cleanliness and proper sanitary con- 
ditions around our homes, horselots, school houses, and 
churches, would soon put an end to the malady. 

The following incident which occurred in one of the prisons 
in the Philippine Islands, illustrates the effects that hook- 
worms have on a community. Attention was called to the fact 
that about seventy out of every thousand of the inmates died 
every year from diseases which were not considered so fatal 
as to give this high death rate. A systematic examination of 
these prisoners revealed that a large majority had hookworm 
disease. All suffering from it were treated and the following 
year only twelve out of every thousand died. It is not unrea- 
sonable to suppose that this disease caused many deaths 
among the prisoners held at Andersonville during the Civil 
War. A certain young man in a Southern school, in the 
beginning of his high school life, was always at the foot of his 
class. Every form of punishment used in this institution was 
tried on this boy but with no result. He was examined and 
found to be suffering with hookworm disease, and in less. than 
two months after treatment, he ranked among the best students 
and brightest minds in his school. 

32 



Advice to Sufferers: — Wherever symptoms of this dis- 
ease are discovered, or suspected, medical advice should be ob- 
tained. The malady yields rapidly to treatment, and this is 
simple and inexpensive. The diagnosis is easily made by 
microscopical examination. 

(For circulars on Sanitary Surface closets and other infor- 
mation concerning this subject, write to the Georgia State 
Board of Health, Atlanta, Ga. 




Fig. 3. 



33 



CHAPTER XIV. 
INSECTS INJURIOUS TO HEALTH. 

It is a known fact that many diseases are transmitted 
by insects. A certain species of the mosquito carries the infec- 
tion of malaria, and another, the germ producing yellow fever. 
The common "house fly" on account of his filthy habits, is 
known to carry the germs of many communicable diseases on 
his feet and to deposit them on our food. Such an important 
part does he play in the transmission of typhoid fever that he is 
often spoken of as the "typhoid fly." The ordinary cat or dog 
flea as well as the rat, is supposed to carry the germs of bu- 
bonic plague. It is well then to consider the means of pro- 
tection from typhoid, malarial, and yellow fever, in so far as 
insects are concerned. 

The house fly is born in filth, lives on filth, and carries with 
him filth. Protection from him means protection from 
many diseases. Sanitation is our only safeguard. Keep a 
clean stable, have on your premises a sanitary closet, and 
keep both clean ; screen doors and windows, and when a fly 
gains entrance to your dining room, kitchen, or house, kill 
him before he can do damage. Remember that he does not 
wipe his feet. 

Inasmuch as there are two species of the disease-carrying 
mosquito, which are numerous in our State, a short description 
of their peculiarities is not without interest. 

The malaria-bearing mosquito is known as the Anopheles. 
His wings are more or less spotted. When resting on a sur- 
face, the Anopheles mosquito has the appearance of standing 
on his head. His body and wings are in line with his beak. 
This mosquito rests during the day and bites during the 
night. 

The yellow fever mosquito, or Stegomyia, is slightly larger 
than the ordinary varieties. He is striped, or zebra-like, and 
can be seen flying around during the day time. 

It must be understood that neither variety of this insect 

34 



can transmit disease without having bitten a person suffering 
from malaria or yellow fever. 

Mosquitoes breed in stagnant water, and for protection 
against them, all pools should be drained and vessels con- 
taining water should be emptied during the summer. Where 
it is impossible to drain, kerosene oil should be poured over the 
surface of all collections of water in the neighborhood of 
houses. For protection during sleep, the bedroom should be 
screened, or a net used. 




AHOPHEUtS. 
(Material Mo*j«lta.) 




Fig. 2. 

COLEX. 

(Common Mosquito.) 



(It will be observed that the body of the malarial mosquito is almost 
straight and sticks out from the surface on which it sits; the body of 
the common mosquito makes an angle and both beak and toil point 
toward the surface to which it is attached.) 



35 



CHAPTER XV. 
THE SCHOOL HOUSE AND SURROUNDINGS. 

The Site : — The elevation and drainage, as well as the item 
of central location, should be considered in selecting a site for 
a school house. The lot should be at least one acre in size, 
and it should be the most healthful and beautiful spot near the 
center of the district. Instead of a bleak and barren hill, the 
children should have the comfort and beauty afforded by trees. 
Sluggish streams and marshes as well as manufacturing plants 
and places where offensive odors are emitted should be avoided. 
The building, as a rule, should be placed on the highest part 
of the lot. Handsome, well kept grounds, as well as modern 
sanitary buildings, are effective factors in raising the standards 
of education. 

Provide walks and flower beds. Their care and culture 
are worth while from every standpoint. 

The Water Supply. — The water supply, whether well, 
spring or stream, should be carefully guarded from pollution 
by surface drainage or filth of any kind. Disease germs are 
often found in water that is agreeable to the taste and perfectly 
transparent. 

In loose, sandy soil, tainted water is often carried under- 
ground for long distances. To guarcf against contamination, 
the water used should come from a source as far removed as 
possible from stables, pig pens, or closets. To prevent drainage 
from these and other dangerous sources, the well should be 
protected by cement or hard brick. A pump should be used 
where a well is the source of water supply; open wells too 
often are made the receptacle of all sorts of undesirable objects 
where children have access to them. 

The sanitary drinking fountain is, of course, to be desired 
wherever attainable. The water bucket and common dipper 
are being forbidden in many schools as prolific sources in 
spreading diseases of the mouth and throat. Water coolers are 

36 




From School Sanitation and Decoration 
D. C. Heath & Company, Publishers. 



cheap, much more economical than bills for medical attention, 
and an individual cup costs only a few cents. 

The Building : — The school room should be approximately 
24x32 feet in size, and at least eleven feet between the floor 
and ceiling. No windows should be placed where children 
must face them when seated at their desks. 

There should be a desk and seat for each pupil, separate 
ante-rooms for the boys and girls, and proper arrangement for 
heat and ventilation. Ante-rooms are not luxuries but necessi- 
ties. Hats, wraps, and dinner pails in the school room are not 
merely unpleasant; they are sources of actual danger to pupils 
and teacher. 

For a pleasing interior, much depends upon the coloring. 
That part of the wall space not occupied by the blackboard 
should be tinted in olive green or £ray, while the ceiling should 
be of some soft cream color. If the light is strong, darker 
shades should be used. Inattention to these matters will be 
followed by injury to the eyes of the pupils. 

Heating and Ventilation : — If stoves must be used, they 
should be placed in the corner, not in the center of the room. 
They should be enclosed in a sheet-iron jacket and some system 
of ventilation provided which will not cause a draft. The doors 
and windows should be left open during intermissions in order 
that a supply of fresh air may be obtained. Much of the rest- 

37 



lessness and fretfulness of the latter part of the session is due 
to the fact that the bodies and minds of the pupils are depressed 
by the poisonous atmosphere, which has been breathed over 
and over again in an improperly ventilated school room. 

Fire Hazard: — Two-story buildings should have outside 
balconies or iron stairs to the ground. Doors should swing 
outward in order to afford ready egress in case of panic. Fire 
drills should be practiced frequently. Where these are prop- 
erly conducted, any ordinary school room can be emptied 
within a few seconds. Inattention to these matters has caused 
sorrow and loss of life. 

Intekiok Decorations : — Do not compel the child to pass 
the formative years of his life in a barren, ugly school room. 
Pictures are cheap. Framed or unframed, they have a 
pleasing and helpful influence. By these, however, the 
"screaming" chromo or miserable daub is emphatically not 
meant. Worse than these are pictures representing scenes of 
horror and bloodshed. A thoughtful observer declared that 
much of the bad manners and roughness exhibited by the pupils 
of a certain school were due to the silent influence of "The 
Massacre of Custer" which with all its bloody details daily 
faced the pupils. Select scenes of great natural beauty, or the 
pictures of noble men and women. 

Hanging baskets or window boxes are not difficult to se- 
cure and are attractive and refining. Almost any neighborhood 
can supply ferns and geraniums, and other flowers may be 
secured at little or no cost. 

Closets : — The feature about the average school which most 
needs attention (and has frequently never received it) is the 
closet. It appears to be regarded as a nuisance without rem- 
edy. We seem to be resigned to the idea that our children 
must be confronted here daily by shameful (and sometimes 
obscene) conditions which are a disgrace to civilization. These 
conditions should no more be allowed at school than at home. 
The school closets should be kept clean. The responsibility 
for this should not be placed upon the teacher alone — particu- 
larly if she is a young lady. 

38 



How should this work be done? Put the closets in 
good condition. Provide a lock and key and require frequent 
inspection. If the dry closet is a necessity, write for a good 
model. The State Board of Health will be glad to furnish this 
without charge. Build a screen before the door and plant 
vines for further protection. Do not neglect this matter. The 
welfare of your child demands this attention on your part. 




Example of a well-screened closet. 



39 



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